Diagnoses and interactive patterns of infants referred to a community-based infant mental health clinic

Miri Keren*, Ruth Feldman, Samuel Tyano

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

112 Scopus citations


Objectives: To describe the distribution of symptoms and diagnoses in a community-based infant mental health clinic and to compare play and feeding interactions of referred and nonreferred infants. Method: The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC 0-3) was used to diagnose 113 referred infants (60% were boys). Thirty additional dyads were matched with 30 nonreferred dyads. Feeding, play interactions, and home environment were compared. Results: Two peaks of referral were found: 0 to 6 and 12 to 18 months. The main reasons for referral were eating problems, sleep problems, aggressive behavior, irritability, and maternal depression. The most common DC 0-3 diagnosis was a combination of primary infant disorder, parent-child relationship disorder, and parental psychopathology. Mothers of referred children provided lower levels of sensitivity, support, and structuring of the interaction, and less optimal home environment. The dyadic relationship showed a lower degree of mutuality and higher negative exchanges. Feeding interactions elicited more negative interactions than play. Conclusions: Infants referred by community health workers showed less optimal mother-infant interactions and had less optimal environment, compared with nonreferred dyads. Symptoms of emotional distress in infancy are best apprehended when assessed in multisituational contexts and formulated in a multiaxial approach.

Original languageEnglish
Pages (from-to)27-35
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number1
StatePublished - 2001


FundersFunder number
SACTA Foundation
General Kupat Holim
Ministerio de Sanidad, Consumo y Bienestar Social


    • Clinic and non-clinic infants
    • Diagnoses
    • Mother-infant feeding and play interactions


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